The Perfect Hospital CEO from Spare Parts

There is no perfect hospital CEO, but there seem to be a lot of imperfect ones lately. There was the star administrator—a COO actually—at a hospital in the Virgin Islands who authorities now allege took more than $1 million "in excess of the amounts specified in the employments contracts." Then federal investigators in Southern California uncovered an alleged scheme to recruit homeless people as claims for government healthcare programs and arrested the CEO of City of Angels Medical Center.

A few incidents for an industry with 5,700 hospitals and a concurrent number of CEOs is not unusual, but even with that caveat you'd be hard pressed to say it has been a stellar year for public perceptions of hospital CEOs in general.

No leader of a hospital or any venture is going to have all the attributes of leadership. If you could, however, build a CEO from a parts supply of strengths, what might they be?

1. The hospital CEO is a servant leader. There has to be only one good reason why a leader would want to be a hospital CEO—because they believe their skill set will leave the place a little better than when they found it. Either it is a calling or not. Being a servant leader also takes care of the core values of honesty and being a good steward of human and financial resources.

2. The hospital CEO is a risk taker. "Gambler" is not the right word because it implies too much left to chance. The days of the old style administrator are gone at top hospitals, but in the future, having a CEO who is willing to make large, fast moves based on sound analysis will be critical.

3. The hospital CEO is cheap (in a good way). There really is no place for extravagance—in executive compensation, amenities, perks, travel—in the hospital C-Suite. Plus extravagance is just asking for attention from the media, regulators, lawmakers and all sorts of people you do not want attention from.

4. The hospital CEO has strong assistant coaches. One leadership philosophy attributed to the late 'Bama coach Bear Bryant was that he did not coach players, he coached the assistant coaches. The best leaders in healthcare get a top-flight senior leadership team and support them.

5. The hospital CEO attracts people. Not every leader can or should be a motivational speaker. Some lead with quiet dignity. Others use zany tricks to fire up the staff. But there is no denying that in an industry staffed by people who are mission-oriented anyway, they will expect the head of the group to set the culture.

6. The hospital CEO rocks the babies once in a while. Maybe the correct term is "rounding with patients," but however you describe it, my perfect hospital leader would take every opportunity to reach out to the most important stakeholders: the patients.

7. The hospital CEO is not over competitive. Every leader has to want to win. But a good leader does not just win for its own sake. So you gained market share at the direct loss of your competitor? Now what? Are going to do a better job of serving the community? Or did you just win? Congratulations.

8. The hospital CEO holds everyone accountable. Middle managers who are middle performers have to go. Bully physicians who are big admitters can go work for someone else. The hospital CEO sets a bar for high achievement based on fair results, and is passionate about making necessary changes when those results fall short.

9. The hospital CEO looks outside. The hospital CEO is the leader of a large employer and may be the single most influential healthcare player in the community. Many of the necessary changes in national healthcare will only take place when healthcare leaders understand such changes may involve some level of sacrifice for their organizations.

John F. Bonamo, MD, executive director of Saint Barnabas Medical Center in Livingston, NJ, spent a week in Beijing, China, earlier this year, teaching hospital CEOs and managers there how to be more effective...